Individual
JILLIAN MIRANDA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
291 DU PAGE ST, MAHOMET, IL 61853-9414
(224) 284-3268
Mailing address
291 DU PAGE ST, MAHOMET, IL 61853-9414
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
041602351
IL
Other
Enumeration date
02/24/2026
Last updated
02/24/2026
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